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563.12.1 Automated Identification. Anh Nguyen University of Illinois Fall 2007. Agenda. Identification Automated Identification Applications Technologies Patient Identification My research project. 1. Identification.

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563 12 1 automated identification l.jpg

563.12.1 Automated Identification

Anh Nguyen

University of Illinois

Fall 2007


Agenda l.jpg
Agenda

  • Identification

  • Automated Identification

    • Applications

    • Technologies

  • Patient Identification

  • My research project


1 identification l.jpg
1. Identification

  • “The function of identificationis to map a known quantity to an unknown entity so as to make it known. The known quantity is called the identifier (or ID) and the unknown entity is what needs identification...” – Wiki

  • No guarantee of provenance or right mapping.


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Need and concern

  • Why Identification:

    • In many cases it is a required part of the workflow.

    • Build up profile (better shopping experience).

    • In security:

      • Authorization = Identification & Authentication + Assigning Privilege(s).(Identity Crisis: How Identification Is Overused and Misunderstood - Jim Harper - debate at Techliberation)

  • Security concerns according to CIA model:

    • Confidentiality: Might not want outside parties to learn your ID (SSN)

    • Integrity: of ID transferred.

    • Availability: the ID is ready when needed.


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2. Automated Identification (AID)

  • The process is done automatically, less human interventions.

    • To save times, increase productivity

    • To operate in harsh environment where it is harmful for human

  • Either replace traditional identification procedure to provide more seamless workflow, or bring new applications:

    • Commercial: Product identification, Supply chain & Logistics, E-Commerce.

    • Healthcare: Equipment tracking/ Patient Identification (later)

    • Transportation: E-Tickets

    • Others: Animal Tracking, Vehicle / People Identification


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AID Applications - Domino

  • Microsoft touch screen computing & domino technology

http://www.news.com/1606-2-6186146.html


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AID Technologies - Barcode

  • Printing ID in a way which is machine readable. Information can be expressed via different symbologies.

  • History: developed in 1948, commercial use 1966,

    not commercially successful until the 1980s.

  • Recent developments: 2D Barcode / stacked barcode, Semacode.

  • Characteristics: cheap, short/long operating range, line of sight, low data rate.

  • Current uses: Groceries – UPC, Books – ISBN, drugs

Barcode, Semacode, UPC, ISBN – Wikipedia


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Magnetic Stripe Card

  • Storing data by modifying the magnetism of tiny iron-based magnetic particles on a band of magnetic material, as in video tape.

  • Sticking a piece of magnetic tape to a plastic card base.

  • Characteristics: cheap, higher data rate, near operating range, inconvenient (operation + reliability), low coercivity card easily damaged.

  • Highly standardized.

  • Current uses: ID cards (UID), Credit & Debit Cards, Subway and Bus Card.


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Smart Card

  • Adding processing power: any pocket-sized card with embedded integrated circuits which can process information.

  • Contact, contactless. Contactless and RFID.

  • Characteristics: has processing power, often come with tamper resistant feature, short operating range (ISO 14443 – 10cm, ISO 15693 – 50cm), more expensive.

  • Current uses: Mobile phone SIM, ATM Cards, contactless CC/DC, smart driver licenses.

RFID Vs Contactless Smart cards – An unending debate - Parul Oswal – 2006


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Biometrics

  • Uniquely recognizing humans based upon one or more intrinsic physical or behavioral traits. (but must be unique)

  • Characteristics: convenient / inconvenient, not very reliable (collision, effect of aging), usually more expensive.

  • Current uses: Personal laptops, digital IDs, ePassport (US, Brazil, Germany).

  • Concerns: once compromised it is compromised for life, danger to owner.

Biometrics - Wikipedia


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RFID

  • Using radio frequency to transfer identifier.

  • Characteristics: very flexible (HF/LF/UHF, active/passive, implantable..), convenient, does not require line of sight.

  • Concerns: privacy, cancer (implantable tags).

  • Emerging market: DoD and Wal-Mart’s mandate, Prescription Drug Marketing Act (PMDA) - pharmaceutical supply chain (pedigree system by Dec 2006 – FDA), China national ID card, Qatar National Identification Project...


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3. Patient Identification

  • Current practice

    • Use text/color wristband

    • Use barcode wristband (ex: University of Wisconsin Hospital – 2004)

    • Use RFID wristband (ex: Bangkok Hospital – 2006, Birmingham Heartlands Hospital - 2007)


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Need to Improve

  • Patient misidentification is identified as a root cause of many errors: adverse drugs event, wrong invasive surgical operations...

  • Study by FDA shows that adverse drug events (ADEs) range from 2.4 percent to 6.5 percent per facility, with a mean rate of 4.3 percent – about 770,000 adverse events in the U.S. each year, $1.7 billion cost – Zebra white paper.

  • Joint Commission – JCAHO - listed “improving patient identification accuracy” as the first of its National Patient Safety Goals introduced in 2003, and this continues to be an accreditation requirement from 2004 to 2008.

  • WHO and JCAHO encourage the use of at least two identifiers.

    (*3)

The Wrong Patient - Mark R. Chassin – 2002, Patient Identification - WHO Press - 2007


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Applications

  • Combine it with automated medication administration systems. U of Wisconsin Hospital reduced medication administration error by 87%.

  • Blood Administration

  • Sample / Treatment Management (to prevent unnecessary procedures)

  • Automated Billing

  • Patient tracking (babies, sleepwalker)


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Technology Trade-off

  • Regulations (FDA, FCC compliance; EU Directive – CE mark)

  • Reliability

  • Privacy concerns

  • Convenience.

  • Cost for hospital.

  • Cost for patient. (not a big issue)

  • (*4)


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Barcode, Magnetic Stripe, Smart Card

  • Barcode:

    • Advantage: conform to regulation, proven reliability, cheap

    • Disadvantage: inconvenient, limited applications, low capacity, not re-writable.

  • Magnetic Stripe

    • Advantage: conform to regulation, acceptable reliability, cheap, higher capacity.

    • Disadvantage: inconvenient, limited applications, not easily re-writable

  • Smart card

    • Advantage: conform to regulation, high reliability, high capacity, flexible (contact/contactless, rewritable/not), computation & security features.

    • Disadvantage: more expensive, limited applications (range).


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RFID, Biometrics

  • RFID

    • Advantage: higher capacity, more applications, convenient, flexible (long/short range, re-writable/not, passive/active)

    • Disadvantage: regulation conformation, reliability (metal & liquid), privacy concerns (more engineering researches), more expensive.

  • Biometrics

    • Advantage: conform to regulation, convenient, no extra cost for patient.

    • Disadvantage: limited applications, no extra information, most expensive (for hospital), reliability improvement.

http://www.pdcorp.com/healthcare/case-study-chang-gung-hospital.html


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My research

  • Working with Ayesha:

  • “To design, implement and verify a system that will enable clinicians to gather, verify and store medical device reading in an automated fashion”

Medical Device

reading

(Nurse ID, Patient ID, reading)

Ser-ver

Patient ID

Nurse info, patient info, human readable reading (*)

Yes/ No

Patient

(*)

Yes/No

Nurse ID

Nurse

https://agora.cs.uiuc.edu/display/cs598cag/Automated+Medical+Data+Acquisition


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Conclusion

  • Automated Identification is very useful.

  • RFID is an emerging technology.

  • Patient Identification need to be improved. And could be done using AID.

  • Each AID technology has its own advantage and disadvantage.

  • More researches to prove/improve reliability of RFID and Biometrics, design so that RFID will conform with EMC requirements.


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References

  • Identity Crisis: How Identification Is Overused and Misunderstood - Jim Harper - 2006

  • www.rfidjournal.com

  • www.rfidupdate.com

  • Patient Identification - Patient Safety Solutions - volume 1, solution 2, May 2007 - WHO Press

  • Patient identification - a crucial aspect of patient safety - patient Safety First

  • The Wrong Patient - Mark R. Chassin, MD, MPP, MPH, and Elise C. Becher, MD, MA* - 4 June 2002 | Volume 136 Issue 11 | 826-833

  • It's All in the Wrist: Improving Patient Safety with Bar Code Wristbands – Zebra – 2006

  • A wearable device for a fully automated in-hospital staff and patient identification - M. Cavalleri, R. Morstabilini, G. Reni – 2004

  • Interoperability Issues regarding Patient Identification in Europe - C. Quantin et al - IEEE EMBS - 2007